Neuroscience of Internet Pornography Addiction: A Review and Update

Problematic pornography use and novel patterns of escalating use: A cross-sectional network analysis with two independent samples

Modern internet pornography allows users to harness sexual novelty in numerous ways, which can be used to overcome desensitisation through increasing volume of use (quantitative tolerance), progressing to more stimulating genres (qualitative escalation), skipping between stimuli (tab-jumping), delaying orgasm ('edging'), and engaging in pornographic binges. However, existing research has not yet evaluated how these potentially reciprocal consumption patterns relate to problematic pornography use (PPU). To this end, we recruited two independent samples of male pornography users (N1 = 1,356, Mage = 36.86, SD = 11.26; N2 = 944, Mage = 38.69, SD = 12.26) and examined the relationships between these behavioural dimensions and self-reported difficulties in controlling one's pornography use. Data were analysed through the network analysis approach (using Gaussian graphical models). As hypothesised, i) quantitative tolerance was centrally placed within the overall network, and ii) acted as a statistical bridge node between other patterns of pornography use (e.g., pornographic binges), and all measured facets of PPU. Our results are consistent with other emerging literature suggesting that tolerance, pornographic binges, tab-jumping, and edging behaviours as relevant features ofPPU, and that upscaling overall usage may connect broader patterns of use with problematic engagement. Clinical and theoretical implications, as well as future research directions, are discussed.

Relationship Between Atypical Sexual Fantasies, Behavior, and Pornography Consumption

Paraphilia is a condition in which the sexual excitement relies on fantasizing and/or participating in unusual sexual behaviors although the line between "normal" and "abnormal" has been disputed. The project aimed to explore which sexual fantasies and behaviors are common and uncommon in the general population. Furthermore, the relationship between sexual fantasies, sexual behaviors, and problematic pornography consumption was examined. Finally, the impact of gender was assessed. Analyses were conducted on a sample of 139 participants. Correlations were found between fantasies, behaviors, and problematic pornography consumption. Furthermore, gender differences were found for both sexual fantasies and problematic pornography consumption. Finally, multiple regression revealed that age, gender [Men], fantasies, and behaviors were significant predictor of problematic pornography consumption. Those findings are in-line with previous studies which highlighted that the threshold to consider a sexual practice as being abnormal needs to be reconsidered on the basis of self-reported fantasies and behaviors in the general population.

From "online brains" to "online lives": understanding the individualized impacts of Internet use across psychological, cognitive and social dimensions

In response to the mass adoption and extensive usage of Internet-enabled devices across the world, a major review published in this journal in 2019 examined the impact of Internet on human cognition, discussing the concepts and ideas behind the "online brain". Since then, the online world has become further entwined with the fabric of society, and the extent to which we use such technologies has continued to grow. Furthermore, the research evidence on the ways in which Internet usage affects the human mind has advanced considerably. In this paper, we sought to draw upon the latest data from large-scale epidemiological studies and systematic reviews, along with randomized controlled trials and qualitative research recently emerging on this topic, in order to now provide a multi-dimensional overview of the impacts of Internet usage across psychological, cognitive and societal outcomes. Within this, we detail the empirical evidence on how effects differ according to various factors such as age, gender, and usage types. We also draw from new research examining more experiential aspects of individuals' online lives, to understand how the specifics of their interactions with the Internet, and the impact on their lifestyle, determine the benefits or drawbacks of online time. Additionally, we explore how the nascent but intriguing areas of culturomics, artificial intelligence, virtual reality, and augmented reality are changing our understanding of how the Internet can interact with brain and behavior. Overall, the importance of taking an individualized and multi-dimensional approach to how the Internet affects mental health, cognition and social functioning is clear. Furthermore, we emphasize the need for guidelines, policies and initiatives around Internet usage to make full use of the evidence available from neuroscientific, behavioral and societal levels of research presented herein.

Predictors of compulsive cyberporn use: A machine learning analysis

Introduction

Compulsive cyberporn use (CCU) has previously been reported among people who use cyberporn. However, most of the previous studies included convenience samples of students or samples of the general adult population. Research examining the factors that predict or are associated with CCU are still scarce.In this study, we aimed to (a) assess compulsive cyberporn consumption in a broad sample of people who had used cyberporn and (b) determine, among a diverse range of predictor variables, which are most important in CCU scores, as assessed with the eight-item Compulsive Internet Use Scale adapted for cyberporn.

Materials and Methods

Overall, 1584 adult English speakers (age: 18-75 years, M = 33.18; sex: 63.1 % male, 35.2 % female, 1.7 % nonbinary) who used cyberporn during the last 6 months responded to an online questionnaire that assessed sociodemographic, sexual, psychological, and psychosocial variables. Their responses were subjected to correlation analysis, analysis of variance, and machine learning analysis.

Results

Among the participants, 21.96% (in the higher quartile) presented CCU symptoms in accordance with their CCU scores. The five most important predictors of CCU scores were related to the users' strength of craving for pornography experiences, suppression of negative emotions porn use motive, frequency of cyberporn use over the past year, acceptance of rape myths, and anxious attachment style.

Conclusions

From a large and diverse pool of variables, we determined the most important predictors of CCU scores. The findings contribute to a better understanding of problematic pornography use and could enrich compulsive cyberporn treatment and prevention.

Comparing the Effectiveness of Cognitive Rehabilitation and Binaural Beats on Craving and Comorbidities of Sexual Hyperactivity: A Pilot, Exploratory Quasi-Experimental Study

Sexual hyperactivity, often linked with substantial psychological and social disturbances, remains under-researched, particularly in contexts like Iran where cultural and social norms may influence the reporting and treatment of such conditions. This study explores the therapeutic potential of cognitive rehabilitation (CR) and binaural beats (BB) in addressing this issue. The primary objective was to compare the effectiveness of CR and BB in reducing symptoms of sexual hyperactivity and associated comorbid conditions, with a focus on fluctuations in sexual desire and overall mental health. Utilizing a quasi-experimental design, the study involved pretest, posttest, and follow-up assessments to evaluate the interventions' impacts. Recruitment through social media yielded 45 participants from a larger pool, who were then assigned to either the CR group, the BB group, or a control group. The CR and BB interventions were administered over a period of 10 sessions, each lasting 20 min, 3 times a week. Significant improvements were observed in both intervention groups compared to the control group. The CR group showed a marked reduction in Sexual Addiction Screening Test (SAST) scores from an initial average of 24.87 to 6.80 at follow-up, indicating a reduction in symptoms of sexual hyperactivity. The BB group also showed improvement, with SAST scores decreasing from 19.93 to 9.57. In terms of mental health comorbidities, the Depression, Anxiety, and Stress Scale (DASS-21) scores decreased notably in the CR group from a baseline of 8.53 to 3.07 post-intervention, and in the BB group from 10.33 to 5.80. Both interventions showed similar effectiveness in reducing anxiety and stress, with no statistically significant differences between the groups for most of the outcomes studied, affirming their potential for clinical application.

Problematic usage of the internet among Hungarian elementary school children: a cross-sectional study

INTRODUCTION

Problematic usage of the internet (PUI) is perhaps one of the most frequently studied phenomena of the 21st century receiving increasing attention in both scientific literature and the media. Despite intensive research there have been relatively few meaningful studies among elementary school students in Hungary and worldwide, who may be considered as a high-risk population with regard to problematic internet use. The aim of our study was to carry out a complex research focusing on the prevalence and risk factors of PUI among elementary school children aged 10-15 years (Grade 5-8).

METHODS

Demographics included were gender, age, place of stay, type of residence, family type, parental education, start of internet use, used devices, daily internet use, purpose of internet use, internet accounts, ways of keeping in touch with friends and sporting activities. PUI was evaluated using the paper-based version of the Potentially Problematic Use of the Internet Questionnaire.

RESULTS

Overall, 2000 paper-based questionnaires were successfully delivered and the final analysis included 1168 responses (overall response rate 58.4%). Mean age was 12.55 ± 1.24 years. Female gender (OR = 2.760, p = 0,006, CI 95% 0.065 to 0.384), younger age (11-12 years) (OR = 3.812, p < 0.001, 95% CI: 1.747-4.731), early exposure to the internet (OR = 3.466, p = 0.001, 95% CI 1.535-5.446), living in a small village (OR = 1.081, p = 0.002, 95% CI 1.041-1.186) urgency to answer online (OR = 4.677, p < 0.001, 95% CI: 2.714-6.639), decreased frequency of personal contact with friends (OR = 2.897, p = 0.004, 95% CI: 1.037-1.681), spending more than 6 h online (OR = 12.913, p < 0.001, 95% CI: 10.798-14.892), morning and nighttime internet use (OR = 3.846, p < 0.001, CI 95% 1.886-5.810) and never doing any sports (OR = 2.016, p = 0.044, 95% CI: 1.050-3.354) were independently associated with problematic internet use.

CONCLUSIONS

Based on the results of our questionnaire survey more than 10% seemed to be problematic users in our study population, which is a relatively high rate. Early exposure to the internet as well as younger age were strongly related to this phenomenon. Duration of being online as well as daily time interval of internet use are important predisposing factors. Scarcely studied social factors such as being online at the expense of personal relationships and the lack of physical activity should be payed more attention to prevent the development of PUI.

Internet Addiction Management: A Comprehensive Review of Clinical Interventions and Modalities

Internet addiction is a pervasive and complex issue that has gained increasing attention in the digital age. This comprehensive review provides an in-depth exploration of clinical interventions and modalities for managing internet addiction. It begins by examining the diagnostic criteria and assessment tools used to identify internet addiction, highlighting the diverse subtypes and varying degrees of severity. Subsequently, the review delves into various clinical interventions, including psychotherapeutic approaches like cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and mindfulness-based interventions. Pharmacological interventions, technology-based tools, and integrative approaches are also thoroughly analyzed. The review also outlines various treatment settings and modalities such as inpatient treatment centers, outpatient clinics, telehealth, support groups, and prevention programs for schools and communities. Furthermore, it discusses the efficacy and challenges associated with managing internet addiction, emphasizing the need for effective interventions, relapse prevention, ethical considerations, and addressing stigma and access barriers. In conclusion, the review offers practical implications for clinical practice. It emphasizes future research's importance in refining diagnostic criteria, exploring emerging technologies, and adapting interventions to an ever-evolving digital landscape. This comprehensive review is a valuable resource for clinicians, researchers, and policymakers seeking to understand and address the complexities of internet addiction.

Emotional processing deficits in individuals with problematic pornography use: Unpleasant bias and pleasant blunting

Background and aims

A growing body of evidence indicates a connection between emotional processes and the emergence and progression of addiction. However, scant research has examined the involvement of emotional processing within the framework of problematic pornography use (PPU). This study aimed to examine the electrophysiological and subjective differences in emotional processing between male individuals with PPU and healthy controls (HCs) following exposure to everyday affective images.

Methods

Event-related potentials (ERPs) were recorded from 42 PPU participants (mean age = 20.14 years, SD = 1.35) and 45 HCs (mean age = 20.04 years, SD = 1.45) during an oddball task, in which unpleasant, pleasant, and neutral images were presented as deviant stimuli, while a neutral kettle image served as the standard stimulus. The Self-Assessment Manikin (SAM) was employed to assess participants' subjective experience on the dimensions of valence and arousal.

Results

Regarding subjective measures of emotion, individuals with PPU reported lower valence ratings for unpleasant images compared to HCs. In terms of electrophysiological measures of emotion, PPU participants reported larger P2 amplitudes for unpleasant pictures compared to both pleasant and neutral pictures. Moreover, HCs showed enhanced P3 amplitudes in response to pleasant images compared to neutral images, whereas this effect was not observed in PPU participants.

Discussion and Conclusion

These findings indicate that individuals with PPU may display deficits in emotional processing characterized by enhanced responsiveness to negative stimuli and attenuated responsiveness to positive stimuli. The heightened sensitivity to negative stimuli may contribute to the inclination of individuals with PPU to engage in pornography as a coping mechanism for stress regulation. Conversely, their diminished sensitivity to positive stimuli presents a challenge in seeking alternative natural rewards to counter potentially addictive behaviors.

Two subtypes of compulsive sexual behavior disorder

Models explaining addictive behaviors such as the Interaction of Person-Affect-Cognition-Execution (I-PACE) model emphasize the importance of reinforcement mechanisms for developing and maintaining these behaviors, including compulsive sexual behavior disorder (CSBD) as well as personal characteristics as vulnerability factors. This study aimed to determine whether there are CSBD subtypes distinguished by reinforcement sensitivity. We hypothesize that one subtype is sensitive to positive reinforcement (C+subtype) and one is sensitive to negative reinforcement (Ȼ-subtype). We calculated a cluster analysis with data from 62 patients with CSBD and tested differences between the identified clusters by t-test. The sample consisted only of men. Cluster variables were: the sensitivity to the Behavioral Inhibition and Approach System (BIS/BAS), the severity of depressive symptoms (BDI-II), the severity of Trait Anxiety (STAI-T), Sexual Sensation Seeking (SSSS), Thrill- and Adventure-Seeking (SSS-V subscale), Disinhibition (SSS-V subscale), Experience Seeking (SSS-V subscale), and Boredom Susceptibility (SSS-V subscale). Between-cluster differences were analyzed for Trait Sexual Motivation (TSMQ) and Sexual Compulsivity (SCS). The results showed a two-cluster solution with cluster 1 representing patients sensitive to negative reinforcement (Ȼ-subtype) and cluster 2 representing patients sensitive to positive reinforcement (C+subtype). No significant difference in symptom severity of Sexual Compulsivity between clusters was found. Cluster 2 showed higher Importance of Sex and a higher motivation to seek sexual encounters than cluster 2. We found a two-cluster solution regarding reinforcement sensitivity in patients with CSBD. This may have clinical implications regarding individual therapy by focusing on the underlying maintenance mechanisms.

The riddle of deliberate self-harm: Physiological and subjective effects of self-cutting cues in patients with borderline personality disorder and healthy controls

Self-harming behavior is a core symptom of borderline personality disorder. Self-report studies show a correlation between a lack of self-reported negative feelings toward self-cutting cues and the likelihood of future self-destructive behavior. Despite these findings, there has so far been insufficient investigation into the implicit emotional processes evoked by this stimulus type. Forty patients with borderline personality disorder and 35 healthy controls between 20 and 50 years of age were confronted with pictures of self-cutting cues and affective reference pictures. A startle reflex paradigm was used for measuring implicit emotional responses, and the Self-Assessment Manikin was used for subjective responses. In line with previous studies, the patients rated the self-cutting pictures significantly less negatively than healthy individuals. On the physiological level, a significant startle inhibition was observed, indicating an activation of the behavioral approach system. A more detailed analysis showed that this startle inhibition effect was specific to scary pictures, whereas no such effect was observed for bloody wounds and self-cutting instruments. For pleasant standard pictures, in contrast, no startle reflex inhibition and no increase in emotional arousal parameters were found. The data replicate the findings of previous studies, demonstrating a generally diminished emotional reactivity to pleasant stimuli in patients with borderline personality disorder. In addition, a physiological approach reaction to self-cutting pictures was found, especially for the scary pictures. These results might indicate a positive identification with the long-lasting consequences of self-cutting behavior in the patients. Implications for therapy are discussed.

Clarifying and extending our understanding of problematic pornography use through descriptions of the lived experience

Problematic pornography use (PPU) is a complex and growing area of research. However, knowledge of the PPU lived experience is limited. To address this gap, we conducted an online qualitative study with 67 individuals who self-identified as having problematic pornography use (76% male; Mage = 24.70 years, SD = 8.54). Results indicated several dimensions that have not been fully explored in the literature. These included various mental and physical complaints following periods of heavy pornography use, sexual functioning deficits with real partners, and a subjectively altered state of sexual arousal while using pornography. Moreover, we expanded on current knowledge regarding the inner conflict associated with PPU and clarified the ways that users can progress to increasingly intensified patterns of pornography use, such as tolerance/escalation and pornographic binges. Our study highlights the complex and nuanced nature of PPU and provides suggestions for future research and clinical practice.

Video game addiction in psychiatric adolescent population: A hospital-based study on the role of individualism from South China

BACKGROUND

For decades, video game-related behaviors have been investigated in different psychologic research, much of whose attention has been paid to video game addiction (VGA), while the differences between VGA and social media addiction (SMA) should have deserved more attention. In addition to detecting common risk factors of VGA, one core question is whether social inclination (individualism or collectivism) matters.

OBJECT

The objectives of this study were to clarify the prevalence of VGA and SMA,, identify the influencing factors of VGA, and clarify the relationships between VGA and adolescents' individualism-collectivism inclination.

METHOD

The survey was conducted among 110 adolescent psychiatric patients. For each interviewee, psychological scales were filled face to face. Path analysis was used to examine the causation structure of the childhood trauma-related symptoms.

RESULT

The prevalence of VGA was 40.9% (45 out of 110), and it was 41.8% for SMA (46 out of 110); childhood trauma, social media addiction, the individualistic inclination, and the rate of homosexuality were observed to be independent indicators for video game addiction (r2  = 0.46).

CONCLUSION

Psychological counseling on patients' internet-related behaviors may focus on the individualistic personality and possible childhood trauma, which are two important risk factors of video game addiction. It is recommended to distinguish between video game addiction and social addiction in clinical practice.

Decision making and executive functions in problematic pornography use

Introduction

Previous research on cognitive functions in Compulsive Sexual Behavior Disorder (CSBD) and problematic pornography use (PPU) reported inconsistent findings and mostly included sexual pictures in the used tasks. The role of general executive functions and cognitive competences (without the presence of appetitive stimuli) in the context of PPU is largely unexplored.

Methods

This study investigated differences between individuals with high versus low problem severity of PPU regarding decision making and executive functions. The sample of the laboratory study consisted of N = 102 male adults. Besides measures of trait impulsivity, we used standard neuropsychological tests (Trail Making Test and three-back working memory task) and an intertemporal risky choice paradigm, the Cards & Lottery Task (CLT).

Results

The results show heightened impulsivity (urgency and deficits in perseverance) in individuals with high PPU, but no differences regarding performance in the CLT and executive function tasks.

Discussion

The findings indicate that PPU might be associated with impulsive behavior when experiencing strong emotions (urgency) and deficient cognitive performance especially in the presence of sexual stimuli but not in general.

Biopsychosocial Determinants of Problematic Pornography Use: A Systematic Review

Background

Although some studies have examined the determinants of problematic pornography use (PPU), few systematic comparisons of risk profiles have been conducted so far. Research on risk profiles can shed a bright light on our knowledge of both the early diagnosis and etiology of such highly prevalent disorders. Accordingly, the present study aimed to provide a comprehensive overview of the determinants of PPU.

Methods

Scopus, Web of Science, PubMed, and PsycINFO databases were systematically searched, and relevant English articles, including longitudinal and cross-sectional studies on risk factors published from January 2000 to February 2022 were reviewed.

Findings

The determinants of PPU extracted from the investigated studies (n=66) were summarized and clustered into biological, psychological, and social categories. The findings indicated that ventral striatum activity is a consistent biological factor which plays a key role in the development of PPU, while there were other psychological factors influencing PPU as mentioned in several studies, including craving, low self-esteem, sexual arousal, coping styles, stress, frequent pornography watching, avoidance, negative beliefs, and emotional deficiency. In addition, the social factors affecting PPU have been reported to be male gender, age, religion, moral incompatibility, and loneliness. According to these results, the identified factors could be considered in preventive treatment.

Conclusion

This systematic review provided a comprehensive overview of the biopsychosocial determinants of PPU by analyzing 66 articles mostly from Europe and North America. Most studies showed that ventral striatum activity, craving, self-esteem, stress, frequent pornography watching, gender, age, and religion are related to PPU.

Profiles of Pornography Use Based on Addictive Mechanisms and Psychopathological Features

Studies using person-centered approaches to further explore the profiles of pornography users throw their psychiatric features are lacking. This study was designed to examine the different profiles of pornography users based on the addictive dimensions of Problematic Pornography Use (PPU) and to characterize these profiles according to psychopathological variables such as depression, anxiety, attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). A sample of 1001 French adults participated to a survey containing scales related to psychopathological variables, cybersexual addiction and PPU. PPU was assessed with the French Version of Problematic Pornography Consumption Scale (Fr-PPCS-18). An Agglomerative Hierarchical Classification was performed on the basis of FR-PPCS-18. A student's t-test was used to observe PPU and psychopathological differences between profiles. Findings revealed three profiles of users: non-problematic users (66.5%), at-risk users (29.9%), and problematic users (3.6%). There were significant differences between the three profiles concerning levels of global PPU, PPU mechanisms, cybersexual addiction symptoms, ADHD symptomatology and depressive symptomatology. Results confirmed the existence of different levels of severity of pornography use corresponding to three different profiles. Also, findings revealed the influence of ADHD symptoms, obsessive-compulsive symptoms and depressive symptoms on PPU.

Effects of a 7-Day Pornography Abstinence Period on Withdrawal-Related Symptoms in Regular Pornography Users: A Randomized Controlled Study

Little is known about whether withdrawal-like symptoms manifest when regular pornography users attempt to abstain from pornography. The present study used a randomized controlled design to examine whether (1) negative abstinence effects that may be potentially reflective of withdrawal-related symptoms manifest when a non-clinical sample of regular pornography users attempt to abstain from pornography for a 7-day period and (2) these negative abstinence effects would only manifest (or manifest more strongly) for those with higher levels of problematic pornography use (PPU). A total of 176 undergraduate students (64.2% female) who were regular pornography users (defined as having used pornography ≥ three times a week in the past 4 weeks) were randomly assigned to an abstinence group (instructed to attempt abstinence from pornography for 7 days, n = 86) or a control group (free to watch pornography as usual, n = 90). Participants completed measures of craving, positive and negative affect, and withdrawal symptoms at baseline and each night of the 7-day period. Contrary to the confirmatory hypotheses, there were no significant main effects of group (abstinence vs. control) or group × PPU interaction effects on any of the outcome measures, controlling for baseline scores. These findings indicate that no evidence of withdrawal-related symptoms was found for abstaining participants, and this was not dependent on level of PPU. However, exploratory analyses showed a significant three-way interaction (group × PPU × past 4-week frequency of pornography use [FPU]) on craving, where an abstinence effect on craving was found at high levels of PPU only once past 4-week FPU reached the threshold of daily use. While these exploratory findings should be interpreted with caution, they suggest that abstinence effects could potentially manifest when there is a combination of high PPU and high FPU-a hypothesis that warrants investigation in future prospective abstinence studies.

Computational models of behavioral addictions: State of the art and future directions

Non-pharmacological behavioral addictions, such as pathological gambling, videogaming, social networking, or internet use, are becoming major public health concerns. It is not yet clear how behavioral addictions could share many major neurobiological and behavioral characteristics with substance use disorders, despite the absence of direct pharmacological influences. A deeper understanding of the neurocognitive mechanisms of addictive behavior is needed, and computational modeling could be one promising approach to explain intricately entwined cognitive and neural dynamics. This review describes computational models of addiction based on reinforcement learning algorithms, Bayesian inference, and biophysical neural simulations. We discuss whether computational frameworks originally conceived to explain maladaptive behavior in substance use disorders can be effectively extended to non-substance-related behavioral addictions. Moreover, we introduce recent studies on behavioral addictions that exemplify the possibility of such extension and propose future directions.

Sex, ducks, and rock "n" roll: Mathematical model of sexual response

In this paper, we derive and analyze a mathematical model of a sexual response. As a starting point, we discuss two studies that proposed a connection between a sexual response cycle and a cusp catastrophe and explain why that connection is incorrect but suggests an analogy with excitable systems. This then serves as a basis for derivation of a phenomenological mathematical model of a sexual response, in which the variables represent levels of physiological and psychological arousal. Bifurcation analysis is performed to identify stability properties of the model's steady state, and numerical simulations are performed to illustrate different types of behavior that can be observed in the model. Solutions corresponding to the dynamics associated with the Masters-Johnson sexual response cycle are represented by "canard"-like trajectories that follow an unstable slow manifold before making a large excursion in the phase space. We also consider a stochastic version of the model, for which spectrum, variance, and coherence of stochastic oscillations around a deterministically stable steady state are found analytically, and confidence regions are computed. Large deviation theory is used to explore the possibility of stochastic escape from the neighborhood of the deterministically stable steady state, and the methods of an action plot and quasi-potential are employed to compute most probable escape paths. We discuss implications of the results for facilitating better quantitative understanding of the dynamics of a human sexual response and for improving clinical practice.

Physiological, Psychosocial and Substance Abuse Effects of Pornography Addiction: A Narrative Review

Internet pornography provides explicit content in various forms and can progress from habit to addiction. The consumption of online porn has risen due to the general use of current technology. The main reasons people consume it are sexual arousal and sexual enhancement. We planned this review study to identify the reasons for online pornography utilization, the mechanisms involved in its addiction, and its physiological, emotional, behavioral, social, and substance abuse effects. After a detailed literature search using PubMed Central and Google Scholar, four case studies and nine original articles from 2000 to 2022 were included. The main findings of the literature demonstrated that watching porn was most frequently done out of boredom, for sexual gratification, and to pick up new fashion and behavior ideas from these movies. In all facets of the users' lives, negative consequences were seen. Due to the explosion of new technologies, online pornography has risen to an alarming level, which has very injurious effects on societies and individuals. Therefore, it is high time to get rid of this addiction to protect our lives from its harmful effects.

Desire thinking and craving as predictors of problematic Internet pornography use in women and men

INTRODUCTION

According to the recent adaptation of the I-PACE model, desire thinking and craving might be closely related to problematic Internet pornography use. The overall aim of the present study was to investigate the role of two components of desire thinking (imaginal prefiguration and verbal perseveration) and craving in problematic Internet pornography use. Furthermore, we examined gender differences in the underlying mechanism linking desire thinking to problematic Internet pornography use.

METHOD

A total of 414 Italian adults (mean age = 27.55 years, SD = 6.13; age range = 18-58; 53.6 % men) participated in this study. Participants completed an online survey to assess problematic Internet pornography use, pornography craving, desire thinking and problematic Internet use. Path analyses and a multi-group approach were used to test the relationships among variables and to explore gender differences.

RESULTS

Imaginal prefiguration was associated to pornography craving which, in turn, was associated to verbal perseveration as proximal antecedent of problematic Internet pornography use, above and beyond the effect of age, relationship status, and problematic Internet use. Two paths significantly differed between men and women: the path between verbal perseveration and problematic Internet pornography, which for women was weaker and did not reach significance; and the path between problematic Internet use and problematic Internet pornography use that was not significant for women.

CONCLUSIONS

In line with the I-PACE model, the present study provided support for the potential role of desire thinking in problematic Internet pornography use as a specific Internet-use disorder and expanded the literature in the field by testing unexplored gender differences. Preventive and clinical implications are discussed.

Making Sense of Jiese: An Interview Study of Members from a Porn-Free Self-Help Forum in China

About 6 million men in China engage in jiese (abstaining from masturbation and porn) and call themselves jieyou (porn-free self-help community members). In this article, we sought to unpack how the idea of jiese took root in Chinese historical, social, and cultural contexts by interviewing 32 jieyou. Guided by the sensemaking theory, we conducted a critical discourse analysis of participants' responses and ended up identifying four major themes: embodied experiences, jiese as rational and noble, reconstructing the subjectivity of jieyou, and nationalistic sentiments. We found out that jieyou tended to justify their abstinence by seeking sources of legitimacy in traditional Chinese culture, the ideology of healthism, science, and patriotic discourses. We argue that jiese reflects young men's contradictory cultural practices of conservatism, self-medicalization, and neoliberal governmentality.

Aggravation of Obsessive-Compulsive Disorder Due to Excessive Porn Consumption: A Case Report

The past few decades have seen a significant rise in pornography consumption. This has brought into existence a new behavioral addiction, addiction to internet pornography, which impacts the psycho-somatic health of the individuals and people around them. The accessibility, affordability, and anonymity of online pornography have fed the growing popularity of online pornography. The International Classification of Diseases (ICD-11) has included pornography in Compulsive Sexual Behavior Disorder with it being categorized as an impulse control disorder and not necessarily an addictive disorder. However, the recently published Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) does not recognize a diagnosis of sexual addiction/compulsion (including internet pornography). Psychiatry remains an ever-evolving branch, and as the understanding evolves, the schools of thought change as well. The constantly evolving literature on behavioral addictions has helped the understanding that any source capable of stimulating the reward circuitry in an individual can become addictive. The stigma associated with behavioral addictions, particularly pornographic addiction, as well as a lack of awareness, contribute to under-reporting, making the reported cases just the tip of the iceberg. Addictions have been associated with various complications and other psychiatric phenomena. We describe a case of a 28-year-old male with mild features of obsessive-compulsive disorder (OCD) that took major shape with the advent of pornographic addiction. The patient was a known case of exam anxiety, panic attacks, auditory hallucinations, and mild obsessive and compulsive symptoms. However, with the death of his girlfriend's father, a breakup with his girlfriend, and coronavirus disease 2019 (COVID-19), he indulged in porn consumption which soon shifted to religious pornographic content leading to guilt with a fair insight. This later culminated in the aggravation of his OCD with repetitive cleaning activities. The patient was started on pharmacological and behavioral therapy and has responded well in follow-ups. In light of the special presentation of this case, we strongly recommend better reporting of such complications aiding in broadening the understanding of the spectrum of possible psychiatric impacts of pornographic consumption.

Psychometric properties of the Slovenian version of Internet Disorder Scale-IDS-15

BACKGROUND

Conceptualising internet addiction and assessing its symptoms has presented a significant challenge for researchers over the past 25 years. Recently, the Internet Disorder Scale (IDS-15), which is based on the criteria for Internet Gaming Disorder (IGD) from DSM-5, has emerged as a promising instrument to assess internet addiction. The main objective of the present study was to evaluate the psychometric properties of the Slovenian IDS-15.

METHODS

The sample was recruited from the National Survey on the Use of Tobacco, Alcohol and Other Drugs that was conducted in 2018 on a nationally representative sample (N  =  16,000; age range: 15-64 years; 62.4% response rate). The final sample comprised 9,161 participants, with 80.9% reporting having used the internet at least once a week (n  =  7,413). A structured questionnaire was designed and internet addiction was assessed using the IDS-15.

RESULTS

Confirmatory Factor Analysis showed acceptable fit to the proposed four-factor structure of the IDS-15. The reliability, and criterion, convergent and discriminant validity were also found to be adequate with a notable exception of the first item of the scale, as shown by its lower factor loading and higher variability. Additionally, latent profile analysis was used to distinguish between internet users with low (n = 3,818; 51.5%), medium (n = 3,111; 42.0%) and high (n = 484; 6.4%) addiction risk. Furthermore, the high-risk class was associated with higher IDS-15 factor scores, higher frequency of internet use in leisure time, and lower age of first internet use.

CONCLUSIONS

The present study provides new insights about the strengths and shortcomings of the IDS-15. Moreover, the results provide an insight into the prevalence of internet addiction in Slovenia, as well as associations with other potential factors. The results serve as the basis for further analyses on internet addiction epidemiology, policymaking activities, and design for targeted public health interventions in Slovenia.

No significant effect of frequent online sexual behaviour on Pavlovian-to-instrumental transfer (PIT): Implications for compulsive sexual behaviour disorder

Reward based learning is broadly acknowledged to underpin the development and maintenance of addictive behaviour although the mechanism in sexual compulsivity is less understood. Using a Pavlovian-to-Instrumental Transfer (PIT) task we tested whether the motivational aspect of conditioned Pavlovian conditioned stimulus invigorated instrumental responding in relation to specific compatible monetary rewards. Performance on the task was analysed between two groups of males based on Low (N = 38) and High (N = 41) self-report online sexual behaviour (OSB). Psychometric tests including sexual compulsivity scale and behavioural activation/behavioural inhibition (BIS/BAS) were also administered to determine the relationship between OSB and general reward sensitivity. We show clear evidence of acquisition in the Pavlovian and instrumental conditioning phases. Specific transfer effect was greater in the High-OSB group although the difference compared to the Low-OSB group was non-significant. OSB negatively correlated with both BIS and BAS indicative of introversion and low reward sensitivity. OSB positively correlated with sexual compulsivity although it is unclear whether individuals in the High-OSB group considered their behaviour either excessive or problematic. These findings contribute to the ongoing debate regarding the nature of problematic OSB. Fundamental differences in motivational characteristics and mechanism contributing to compulsive behaviour in relation to high-OSB might indicate incompatibility with behavioural addiction models. PIT was not enhanced in high-OSB by appetitive conditioning, although problematic OSB could stem from failure to inhibit actions. Further research should investigate whether aversive conditioning differentially affects responding in high-OSB individuals, potentially explaining perseverant behaviour despite negative consequences.

Association of Cyberbullying and Internet Use Disorder

Purpose of Review

The purpose of this review is to critically assess the published studies on the relationship between cyberbullying and internet use disorder (IUD), and propose directions for further study.

Recent Findings

There were only four prospective studies out of thirty-two reviewed studies conducted since 2004, with only one prospective study conducted during the past 5 years. The field of study has been stagnant during the past 5 years with the vast majority of studies conducted on primary or secondary education and failing to address cyberbullying and IUD in social media and online gaming.

Summary

Cyberbullying and IUD have been described since the nineties, yet there are still significant issues with their definition and research. Lately, both these problematic behaviors are sharing the same environments in social media and online gaming. This critical appraisal of published research examined thirty-two published peer-reviewed studies carried out since 2004. Findings indicate a number of significant issues including an overreliance on cross-sectional study design, near-exclusive focus on primary and secondary education students, widespread employment of unstandardized measures for cyberbullying and IUD, and lack of assessment for objective measures of psychological distress. Directions for future research are offered.

A motivation model of sex addiction - Relevance to the controversy over the concept

An integrative model of sexual addiction is presented, involving a combination of models based upon (i) incentive motivation theory and (ii) the dual organisation of the control of behavior. The model is related to ongoing arguments about the validity of the notion of addiction when applied to sexual behavior. It is suggested that the evidence strongly favors the viability of an addiction model of sex. Strong similarities to the classical addiction to hard drugs are observed and features can be better understood with the help of the model. These include tolerance, escalation and withdrawal symptoms. It is argued that other candidates for accounting for the phenomena, such as obsessive-compulsive behavior, faulty impulse control, high drive and hypersexuality do not fit the evidence. The role of dopamine is central to the model. The model's relevance to stress, abuse, development, psychopathy, fantasy, sex differences, evolutionary psychology and the interaction with drug-taking is shown.

The pornography use and its addiction among emerging adults in Malaysia: Perceived realism as a mediator

Past studies have demonstrated a link between pornography use and addiction to pornography, the underlying mechanism of the association is still unclear. This study intended to examine the mediating role of perceived realism of pornography in the association between pornography use and addiction among emerging adults in Malaysia. This study recruited 222 self-identified pornography users (M age = 21.05; SD Age = 1.68; 75.1% male respondents) via the purposive sampling method. The correlation results indicated positive associations among pornography use, addiction to pornography, and perceived realism of pornography. Further, the perceived realism of pornography significantly mediated the association between pornography use and addiction to pornography after controlling for gender. Thus, this study has provided a fundamental understanding on the perceived realism role of pornography in explaining the association between its use and addiction. Although it is unlikely to stop illegal pornography use, the results pointed out a need to guide emerging adults in pornography use via media literacy programmes.

Addictions: current perspectives

This paper seeks to integrate the perspectives of analytical psychology and neurobiology in order to understand the phenomenon of addiction in contemporary society, taking into account the COVID-19 pandemic. Jung emphasizes the role of the psyche's self-regulation and the development of consciousness in the individuation process. The search for experiences of transcendence is archetypal and can be achieved by the use of some substances or behaviours and can contribute to individuation. However, in contemporary society, many individuals seek to restore internal balance through behaviours that merely soothe discomfort. The difficulty in discerning use, abuse, and dependence, particularly in the case of behavioural addictions, is discussed and neurobiological factors are presented. Empathic relationships play a key role in this process as they can promote the integration of the right and left hemispheres, integrating non-verbal experiences and language, contributing to self-regulation. Jung emphasizes the importance of real encounters in the transformation process. Currently, meetings have become a source of anguish. The author concludes that more than ever it is necessary to invest in the quality of the interactions to prevent and treat addictions.

Antecedents and consequences of internet addiction among school and college students: evidence from India

Purpose

Internet addiction (IA) has become a global health problem. As the research on IA has progressed, this study aims to explore the antecedents and consequences of IA, particularly in the Indian context. A conceptual model was developed, and hypotheses were formulated based on the conceptual model and the hypotheses were tested.

Design/methodology/approach

This study investigated 752 schools and collected students from the southern part of India. First, psychometric properties of the survey instrument were tested, and hierarchical regression was used to test the hypotheses.

Findings

The results revealed that time spent on the internet every day is positively related to IA, internet experience in terms of years is positively related to IA, income and gender moderates the relationship between time spent every day on the internet and internet experience and IA and IA is positively related to time spent on networking, video streaming, short video apps, educational apps, chat apps, online shopping apps, money-involved apps, etc.

Practical implications

The outcomes of this study are essential for the school and college students and their parents. As IA has become chronic in the present-day digital world, it is necessary to take rectification measures to avoid facing the perils of IA. The conceptual model provides a simple framework of explaining how young students spend their time on the internet to become addicted gradually. Furthermore, this study highlights the importance of controlling the younger generation's behavior, particularly regarding internet use.

Originality/value

This study is unique and innovative to the extent that it explores the antecedents of IA and the moderating role of gender and income in the relationship between the time spent on the internet and the IA. To the best of the authors’ knowledge, developing a conceptual model is the first of its kind to study school and college students in India.

Effects of retrieval-extinction training on internet gaming disorder

BACKGROUND AND AIMS

Internet gaming disorder (IGD) leads to serious impairments in cognitive functions, and lacks of effective treatments. Cue-induced craving is a hallmark feature of this disease and is associated with addictive memory elements. Memory retrieval-extinction manipulations could interfere with addictive memories and attenuate addictive syndromes, which might be a promising intervention for IGD. The aims of this study were to explore the effect of a memory retrieval-extinction manipulation on gaming cue-induced craving and reward processing in individuals with IGD.

METHODS

A total of 49 individuals (mean age: 20.52 ± 1.58) with IGD underwent a memory retrieval-extinction training (RET) with a 10-min interval (R-10min-E, n = 24) or a RET with a 6-h interval (R-6h-E, n = 25) for two consecutive days. We assessed cue-induced craving pre- and post-RET, and at the 1- and 3-month follow-ups. The neural activities during reward processing were also assessed pre- and post-RET.

RESULTS

Compared with the R-6h-E group, gaming cravings in individuals with IGD were significantly reduced after R-10min-E training at the 3-month follow-up (P < 0.05). Moreover, neural activities in the individuals with IGD were also altered after R-10min-E training, which was corroborated by enhanced reward processing, such as faster responses (P < 0.05) and stronger frontoparietal functional connectivity to monetary reward cues, while the R-6h-E training had no effects.

DISCUSSION AND CONCLUSIONS

The two-day R-10min-E training reduced addicts' craving for Internet games, restored monetary reward processing in IGD individuals, and maintained long-term efficacy.

"Pornography Addiction": Elements for Discussion of a Case Report

Can Internet pornography use (IPU) lead to addiction? "Pornography addiction" is a highly controversial concept within the scientific community. In the absence of consensus, international classifications do not consider that the concept meets the criteria to be recognized as a distinct diagnostic entity. However, the term "pornography addiction" has now become common parlance and is therefore present in the discourse of patients seeking therapy to address what they perceive as problematic pornography consumption. Drawing on a brief case vignette, presenting the case of a man who views himself as a pornography addict, we offer a critical review of this concept. Different diagnostic hypotheses will be considered. Beyond the diagnostic process, we consider the issue of "perceived addiction" and its relationship with "moral incongruence." From a psychotherapeutic view, we suggest that patients who self-identify as "porn addicts" must be supported using a more comprehensive approach that goes beyond their symptomatic behavior or the manner in which they present or perceive themselves. The proposed therapy did not seek or require an end to the behavior. The therapy approach focused on exploring the patient's history in an attempt to understand the construction of his sexuality and morality. In the case analyzed, focusing on the source of moral incongruence led to the disappearance of IPU and all associated suffering.

Increase in the Prevalence of Online Pornography Use: Objective Data Analysis from the Period Between 2004 and 2016 in Poland

Despite the considerable amount of attention presently devoted to the high accessibility of online pornography, very little formal analyses have been carried out to show how the advent and proliferation of Internet technology has changed the prevalence of pornography use in populations. We conducted a preliminary analysis based on objective website traffic data, representing the changes in the number of (1) Internet users generally and (2) online pornography users specifically, between 2004 and 2016 in Poland. We observed a clear increase in the estimated number of people using online pornography in the analyzed period. The estimated number of general population members viewing pornography on the Internet increased over three times (310%) between October 2004 and October 2016-starting from an estimated 2.76 million in the first period to 8.54 million in the last. At the same time, we did not observe a clear increase in the percentage of Internet users who viewed online pornography in the same time period. Additionally, pornography viewership on the Internet was almost 2 times more prevalent among male (47%) than female Internet users (27%), and most popular in the 18-27 age group. Since our analysis is based on objective data, it does not share the limitations inherent in self-reports. However, our approach also has several important limitations (e.g., the analysis does not include online activity generated on mobile devices and under a private browsing mode); thus, the results should be interpreted with caution.

Self-Perceived Problematic Use of Online Pornography Is Linked to Clinically Relevant Levels of Psychological Distress and Psychopathological Symptoms

Online pornography is a widespread Internet application. As with other Internet applications, in some cases its use can become problematic. First indications point to a link between problematic use of online pornography and psychological distress and general functional impairment. However, to date, there are no standardized criteria for assessing problematic use of online pornography. In this study, we used the Online Pornography Disorder Questionnaire (OPDQ)-an instrument which adapted the official criteria for Internet Gaming Disorder to online pornography-to measure problematic use and investigated to what extent consumers with a self-perceived problematic use of online pornography differed from casual users with regard to their psychological distress. An online sample of German adult visitors to a popular casual dating site completed the OPDQ, the Brief Symptom Inventory (BSI), and provided information on their online pornography use (n = 1539; 72.6% male; 31.43 ± 11.96 years). T-scores for the BSI were calculated and independent t-tests were conducted to compare casual users with consumers with a self-perceived problematic use of online pornography. Of the users, 5.9% fulfilled the criteria for problematic use. This group consumed online pornography for longer amounts of time and showed higher levels of psychological distress (Hedges' g from 0.75 to 1.21). The T-scores of users with self-perceived problematic online pornography use reached clinically relevant levels on all subscales. Overall, the results of the study indicate that self-perceived problematic use of online pornography seems to be linked to severe psychological distress that may warrant clinical attention.

Examining the Problematic Pornography Use Model: A Quantitative Exploration of Dysregulated Pornography Use

BACKGROUND

Questions concerning problematic pornography consumption have been widely discussed, but longitudinal data examining the relationships implicated by problematic pornography use models are rare. To date, two models have been proposed that have sought to elucidate the causal mechanisms involved in a problematic pornography use model, the I-PACE model and the Pornography Problems Due to Moral Incongruence Model.

AIM

We sought to clarify this issue by investigating the prospective association between variables integral to previously proposed addiction models.

METHODS

Using a longitudinal TurkPrime.com sample (N = 317), and a newly developed measure of pornography consumption, we asked participants to answer questions related to their pornography usage, their distress levels, and individual differences over a six-month time frame during 2017.

MAIN OUTCOME

Pornography consumption only led to distress when an individual possessed certain individual differences. Moreover, there was no evidence that pornography use mediated or suppressed the relationship between pornography consumption and distress.

RESULTS

Using a series of mediation/suppression models, we found evidence to support the structure of existing theoretical models; specifically, pornography consumption amplifies the relationship between individual differences (ie, sexual compulsivity and sexual sensation seeking) and distress (ie, depression and sexual esteem) over a six-month time period. However, we failed to observe an association between pornography consumption and distress when sexual compulsivity and sexual sensation seeking were left unaccounted for within the model, suggesting pornography use likely only results in distress in those with certain individual differences. Moreover, there was no evidence that perceptions of problematic pornography use suppressed or mediated the relationship between pornography consumption and distress.

CLINICAL IMPLICATIONS

These findings suggest that targeting specific individual differences -a la Acceptance and Commitment Therapy-rather than pornography consumption attitudes may be a more effective strategy to reduce problematic pornography use.

STRENGTHS & LIMITATIONS

One strength of the current study was that we were able to corroborate previously hypothesized models of problematic pornography consumption. Furthermore, this was done using a newly designed measurement of pornography consumption. However, the study was not without some shortcoming. We were unable to test the pornography problems due to moral incongruence arm of the study, something that previous research has indicated may lead to distress.

CONCLUSION

This paper sought to empirically examine models investigating problematic pornography use. Our findings indicate that pornography consumption will only lead to certain sorts of distress in the presence of specific individual differences ie, sexual compulsivity and sexual sensation seeking.

Transtorno de Jogo: contribuição da abordagem psicodinâmica no tratamento

Resumo Jogos de azar podem ser uma atividade de lazer, mas sua prática em excesso pode levar a consequências adversas, como o Transtorno de Jogo. Apesar dos sérios prejuízos provocados por esse quadro, tanto o Transtorno de Jogo em si quanto estratégias de tratamento são pouco conhecidos no Brasil. Este trabalho aborda o Transtorno de Jogo e seu tratamento, tendo como objetivo explicitar a contribuição da abordagem psicodinâmica. São apresentadas as principais hipóteses psicodinâmicas existentes na literatura e tecidas considerações sobre a psicoterapia psicodinâmica realizada em um serviço que atende jogadores em São Paulo, o Programa Ambulatorial do Jogo Patológico (PRO-AMJO) do Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (IPq HC-FMUSP). Por fim, alguns exemplos de perfis de jogadores patológicos são apresentados.

The moral maze of sex & porn addiction

Sex addiction, a term first coined in the early 80s, has always been met with controversy. Some say the label of addiction is an excuse used by those who have lost their moral compass or refuse to accept responsibility for their sexual choices. Others claim the label is used to pass moral judgement on those whose sex lives or internet viewing habits do not fit societally prescribed norms. The acceptance by WHO of CSBD (Compulsive Sexual Behaviour Disorder) into ICD11 was heralded as a moral victory by the sex addiction naysayers who claimed WHO's position 'proved' it wasn't an addiction; conversely sex addiction professionals claimed victory saying that finally this was a step in the right direction. This paper will explore the divide and provide insight on how using a pure medical model of addiction has contributed and fueled the debate. An alternative model for conceptualization from a biopsychosocial perspective will be provided to suggest ways of moving forward that could ease the controversies as well as opening new areas for research and most importantly, greater understanding and empathy for clients.

Adolescents' Online Pornography Exposure and Its Relationship to Sociodemographic and Psychopathological Correlates: A Cross-Sectional Study in Six European Countries

The aim of the study was to assess the prevalence of online exposure to pornography in European adolescents and its relationship to sociodemographic and psychopathological correlates. A cross-sectional school-based survey of 10,930 adolescents (5211 males/5719 females), aged 14-17 years old (mean age 15.8 ± 0.7) was carried out in six European countries (Greece, Spain, Poland, Romania, the Netherlands, and Iceland). Anonymous self-completed questionnaires covered exposure to pornography, internet use and dysfunctional internet behavior, and psychopathological syndromes (measured by Achenbach's Youth Self-Report). The prevalence of any online exposure to pornography was 59% overall and 24% for exposure at least once a week. The likelihood of online exposure to pornography was greater in male adolescents, heavier internet users, and those who displayed dysfunctional internet behavior. Country-specific analyses confirmed that the gender effect existed in every country, although its strength varied, from an odds ratio of 1.88 in Poland to 14.9 in Greece. Online exposure to pornography was shown to be associated with externalizing problem scale scores, especially rule-breaking and aggressive behavior, but also associated with higher scores in competences, namely activities and social competence. Exposure to pornography is ubiquitous, more relevant to boys, and is associated with both positive qualities/competences and externalizing behavioral problems.

Pornography Addiction: An Exploration of the Association Between Use, Perceived Addiction, Erectile Dysfunction, Premature (Early) Ejaculation, and Sexual Satisfaction in Males Aged 18-44 Years

INTRODUCTION

The way men consume pornography changed over the last decade, with increased numbers of men presenting with self-perceived Internet pornography (IP) addiction and related sexual dysfunction. A lack of consensus and formal recognition in the DSM-5 lead to a variety of definitions of IP addiction. Currently, the majority of evidence linking IP addiction and sexual dysfunction was derived from consumers, case studies, and qualitative research. Where empirical measures were used, researchers found mixed outcomes in sexual response. Inconclusive data appeared to relate to the conflation of IP use and self-perceived IP addiction, and normal variations in sexual response with clinical diagnosis of sexual dysfunction. Thus, further empirical clarification is required to assess the impact of both IP use and self-perceived IP addiction, on men's sexual function.

AIMS

This study has 3 aims: First, to assess if there is an association between IP use alone and erectile dysfunction (ED), premature (early) ejaculation (EE) and sexual satisfaction (SS); Second, to assess whether there is an association between self-perceived IP addiction and ED, EE and SS. Third, to assess whether IP use or self-perceived IP addiction uniquely predicts ED, EE, SS in men.

METHOD

Correlation and regression analysis was conducted on a cross-sectional sample of 942 heterosexual men aged 18-44 years who participated in an online survey sourced from Reddit IP subgroups.

MAIN OUTCOME MEASURES

Cyber-Pornography Use Inventory; International Index Erectile Dysfunction; The Checklist for Early Ejaculation Symptoms; New Sexual Satisfaction Scale; Depression Anxiety Stress Scale-21.

RESULTS

There was no evidence for an association between IP use with ED, EE, or SS. However, there were small to moderate positive correlations between self-perceived IP addiction and ED, EE and sexual dissatisfaction. Further, self-perceived IP addiction uniquely predicted increased ED, EE and individual sexual dissatisfaction. Contrary to expectations, self-perceived IP addiction did not predict sexual dissatisfaction with one's sexual partner.

CONCLUSION

These results suggest that IP use alone does not predict sexual dysfunction. Rather, self-perception of increased IP addiction was related to negative sexual outcomes. Thus, we concluded that subjective interpretation of ones IP use was a contributor to IP related sexual problems in our sample of males who share IP on social media sites. We recommend that clinicians consider self-perceived IP addiction as a possible contributing factor to sexual dysfunction. Whelan G, Brown J. Pornography Addiction: An Exploration of the Association Between Perceived Addiction, Erectile Dysfunction, Premature (Early) Ejaculation, and Sexual Satisfaction in Males Aged 18-44 Years. J Sex Med 2021;18:1582-1591.

The Impact of Negative Mood on Event-Related Potentials When Viewing Pornographic Pictures

Background: Negative affective states may increase the risk for problematic pornography use. Underlying neurophysiological mechanisms are, however, not completely understood. Previous research suggests that the participants' emotional state may affect neural processing of sexual stimuli. The aim of this study was to investigate neural correlates of negative affect-induced alterations in sexual cue reactivity in healthy men. The moderating effects of habitual porn consumption, trait sexual motivation, and symptoms of cybersex addiction were also considered. Method: Sixty-four healthy men engaged in a sexual cue reactivity task (passive viewing of explicit sexual pictures and neutral pictures depicting scenes of social interaction) during negative (n = 32) vs. neutral affect (n = 32), induced via tailored feedback on a performance task. Self-reported sexual arousal and event-related brain potentials indicated cue reactivity and motivated attention. Symptoms of cybersex addiction and trait sexual motivation were assessed with the help of the short Internet Addiction Test, adapted to online sexual activities, and the Trait Sexual Motivation Questionnaire. Results: Negative feedback increased negative affect after the performance task. While sexual pictures compared to neutral pictures elicited significantly larger P300 and late positive potential (LPP) amplitudes, there was no general effect of negative feedback on sexual stimuli-related P300 and LPP amplitudes. In the negative feedback group, men with higher solitary sexual motivation levels showed higher P300/LPP difference amplitudes for sexual stimuli compared to men with lower levels of solitary sexual motivation. The opposite effect was found in the group with neutral feedback. There was no link to other aspects of trait sexual motivation and symptoms of cybersex addiction. Conclusions: Results suggest that higher levels of solitary sexual motivation may enhance motivated attention toward sexual stimuli among men receiving negative performance feedback. Other characteristics of sexual behaviors and traits provided no exploratory value. Future studies extending onto men suffering from compulsive sexual behavior disorder will have to closer look at the neurophysiological bases of why and when some men develop an addictive pornography consumption.

Problematic Internet Use Was Associated With Psychological Problems Among University Students During COVID-19 Outbreak in China

Background: As the coronavirus disease 2019 (COVID-19) pandemic progressed globally, school closures and home quarantine may cause an increase in problematic Internet use among students in universities. Such a traumatic stress event may also contribute to the development of posttraumatic stress disorder (PTSD), depressive, and anxiety symptoms. This study aimed to evaluate the prevalence of PTSD, depressive, and anxiety symptoms as well as the predictive role of problematic Internet use in the above-mentioned psychological problems in university students.

Methods: A cross-sectional study was conducted through an online survey of 8,879 students in China between April 20 and April 26, 2020. The presence of PTSD, depressive, and anxiety symptoms and problematic Internet use were evaluated using PTSD Checklist for DSM-5, the Center for Epidemiologic Studies Depression 9-item scale, the generalized anxiety disorder 7-item scale, and the Young diagnostic questionnaire, respectively. Sociodemographic information and the knowledge, attitude, and practice (KAP) toward COVID-19 data were also collected.

Results: A total of 4,834 (54.4%) participants were female, and 7,564 (85.2%) were undergraduate students. A total of 615 students (6.9%) reported PTSD symptoms; 5.2% (465) and 10.1% (896) reported moderate to severe depressive and anxiety symptoms, respectively. The problematic Internet use was significantly associated with higher risk of PTSD, depressive, and anxiety symptoms (odds ratio 2.662 [95% CI, 2.239–3.165], odds ratio 4.582 [95% CI, 3.753–5.611], odds ratio 3.251 [95% CI, 2.814–3.757], respectively; all P < 0.001). Lower attitude and practice scores also contributed to the risk of depressive, anxiety, and PTSD symptoms (P < 0.05).

Conclusions: Psychological problems should be paid more attention, and problematic Internet use may be a predictor when screening high-risk students for psychological problems. Our results will aid in timely psychological screening, which is meaningful in the prevention and intervention of psychological problems.

Problematic consumption of online pornography during the COVID-19 pandemic: clinical recommendations

The coronavirus disease (COVID-19) pandemic is one of the greatest contemporary challenges. Feelings of fear and uncertainty triggered by this pandemic have had noxious effects on people's mental health. This seems to have increased during quarantine and there is evidence of an intensification of rewarddirected behavior. Nevertheless, there are few studies dealing with pornography consumption during this period. The aim of this manuscript is to contextualize this phenomenon during the pandemic and suggest some clinical recommendations on the matter.

Compensatory Usage of the Internet: The Case of Mukbang Watching on YouTube

OBJECTIVE

Accumulating empirical research has emphasized that a wide range of online activities-such as using social networking sites-can be performed in order to compensate unattained needs or to cope with negative affect and psychopathological symptoms. Although the correlates of problematic social networking use have been extensively investigated, less is known about problematic YouTube use (PYU), an umbrella term grouping a number of different activities (e.g., viewing of online video games, watching specific YouTube channels). Furthermore, nothing is known concerning increasingly popular and distinct YouTube-related activities such as mukbang watching (i.e., watching livestream "eating broadcasts" where someone eats various foods in front of the camera while interacting with viewers). The aim of the present study was to examine the mediating role of problematic mukbang watching (PMW) on the relationships between depression and loneliness with PYU.

METHODS

An online survey that comprised assessment tools for aforementioned variables was administered to 217 mukbang viewers (mean age=20.58 years, range 18-33 years).

RESULTS

Results indicated that PMW was positively related to loneliness and PYU. Depression was positively and directly associated with PYU but was not associated with PMW.

CONCLUSION

Further research is required to better understand the psychological processes underlying problematic mukbang watching and its association with other mental health conditions (e.g., addictive disorders, eating disorders).

Decision-Making in Gambling Disorder, Problematic Pornography Use, and Binge-Eating Disorder: Similarities and Differences

Purpose of Review

The present review attempts to provide a comprehensive and critical overview of the neurocognitive mechanisms of gambling disorder (GD), problematic pornography use (PPU) and binge-eating disorder (BED), focusing specifically on decision-making processes.

Recent findings

GD, PPU and BED have been associated with decision-making impairments both under risk and ambiguity. Features such as intelligence, emotions, social variables, cognitive distortions, comorbidities, or arousal may condition decision-making processes in these individuals.

Summary

Impairments in decision-making seem to be a shared transdiagnostic feature of these disorders We also hypothesized the EG relative to the NEG group would demonstrate weaker relationships between problem-gambling severity and health/functioning measures (e.g., substance use) and gambling behaviors (e.g., more time spent gambling) given that EG would account for some of the variance in the relationships between ARPG and these measures. However, there is varying support for the degree to which different features may affect decision-making. Therefore, the study of decision-making processes can provide crucial evidence for understanding addictions and other disorders with addiction-like symptomatology.

Prevalence of Behavioral Addictions and Their Relationship With Stress and Anxiety Among Medical Students in Saudi Arabia: A Cross-Sectional Study

Behavioral addiction is identified as any compulsive, repeated, and persistent behavior that leads to significant and functionally impairing harm or distress. The aim of this study is to determine the prevalence of internet, video-gaming, and pornography addictions among medical students in Western region. In addition, we intend to investigate the relationship between these behavioral addictions with stress and anxiety. Our study was a cross-sectional study with a sample size of 225. The study participants were medical students in their 3rd, 4th, and 5th academic years from five different medical colleges in Western region. The questionnaire included demographics and adapted five different pre-validated scales: Young's Internet Addiction Test - Short Version (IAT-SV), Internet Gaming Disorder Scale 9 - Short Form (IGDS9-SF), (PPC scale), Perceived Stress Scale (PSS), and Generalized Anxiety Disorder 7-item scale (GAD-7). The IAT-SV scale showed: 71 (31.6%) of the participants had normal internet usage, 51 (22.7%) participants showed problematic usage, and 103 (45.8%) used the internet pathologically. The IGDS9-SF scale had observed the following values: 220 participants (97.8%) were non-disordered, and 5 participants (2.2%) were found to be disordered. Statistical analysis showed a highly significant association between stress and problematic pornography consumption (P < 0.01), and internet addiction (P <0.001). Moreover, there was a significant association between anxiety and internet gaming disorder (P < 0.01). This study showed high prevalence of internet addiction and low prevalence of internet gaming disorder. Also, it gave more understanding to a possible association between these behavioral addictions with stress and anxiety.

Internet and Pornography Use During the COVID-19 Pandemic: Presumed Impact and What Can Be Done

The COVID-19 pandemic continues to cause an immense psychosocial strain worldwide. Excessive use of the internet during these psychologically trying times, fueled by physical isolation as a result of lockdowns, has translated into dysfunctional behaviors. A growing body of evidence suggests an unprecedented increase in internet use and consumption of online pornography during the pandemic, and possibly even directly caused by it. In this review, the authors report data from relevant sources to show the rise in pornography use during lockdowns in different countries worldwide. In addition to a brief overview of the neurobiology of internet addiction broadly and problematic online pornography use specifically, similarities with substance use disorders are explained. Further, the current status of the debate about defining diagnostic criteria is discussed. Finally, the review sheds light on the potential detrimental outcomes during the future post-pandemic "re-adaptation," while simultaneously offering preventative and management strategies for harm reduction. The authors conclude that foresightedness with utilizing existing tools and therapies and exercising appropriate amounts of caution could go a long way in addressing the challenges that lie ahead in the post-pandemic era.

Internet addiction in students from an educational institution in Southern Brazil: prevalence and associated factors

Objective

To evaluate the prevalence of Internet addiction (IA) and its associated factors among students at an Educational Institution in Southern Brazil.

Method

This is a cross-sectional study, targeting a sample of students aged from 14 to 20 years. They were selected by random sampling to be representative of the 4038 students enrolled at the institute at the time. IA was assessed using the Internet Addiction Test (IAT). Screening for anxiety and/or depressive disorders was performed using the Well-Being Index (WHO-5).

Results

The prevalence of IA was 50.8% and the rate was higher among individuals who had screened positive for depressive or anxiety disorders than among those who had not (p = 0.003). There was an association between IA and access to certain types of content, such as gaming (p = 0.010), work and study related content (p = 0.030), and using the internet to access sexual content (p < 0.001).

Conclusion

Further studies are needed to confirm the high prevalence of IA and explore factors associated with it in samples with similar characteristics to ours. The associations between this dependency and positive screening for anxiety and/or depressive disorders and the types of content accessed are an alert to the existence of these important relationships and illustrate the importance of studying them further. Knowledge about these associations provides an opportunity to implement measures for prevention, such as psychoeducation, and to offer adequate treatment.

Profiling of pornography addiction among children using EEG signals: A systematic literature review

Nowadays human behavior has been affected with the advent of new digital technologies. Due to the rampant use of the Internet by children, many have been addicted to pornography. This addiction has negatively affected the behaviors of children including increased impulsiveness, learning ability to attention, poor decision-making, memory problems, and deficit in emotion regulation. The children with porn addiction can be identified by parents and medical practitioners as third-party observers. This systematic literature review (SLR) is conducted to increase the understanding of porn addiction using electroencephalogram (EEG) signals. We have searched five different databases namely IEEE, ACM, Science Direct, Springer and National Center for Biotechnology Information (NCBI) using addiction, porn, and EEG as keywords along with 'OR 'operation in between the expressions. We have selected 46 studies in this work by screening 815,554 papers from five databases. Our results show that it is possible to identify children with porn addiction using EEG signals.